Can you really change lives with a toothbrush? Nursing students say yes

02/15/2013

Can you really change lives with a toothbrush?

Yes, you can, as three UA students proved when they joined forces on a unique Honors Research Project that enabled them to make a difference half a world away.

Erin Rosen, left, Molly Arnold and Kelsey Snyder will graduate in May and begin their careers in health care. Thanks to their Akron Experiences in the classroom and in the community, they’ve already been able to make their mark on a global scale.

The three friends and nursing majors — Erin Rosen, Molly Arnold and Kelsey Snyder — built their project around Rosen's planned mission trip to Bangalore, India, in summer 2012 with the organization Leave UR Mark.

"Erin came to us with an interesting idea," recalls Arnold, of Ontario, Ohio. "What would the health of the people in Bangalore look like after they were provided with supplies and education about specific health practices? Could we empower people, within their culture, to increase positive health behaviors?"

How best to serve?

Rosen, an Akron native, already knew from her first mission trip abroad, to Ghana, West Africa, in summer 2011, that good intentions alone are not enough to overcome language barriers, cultural differences and poverty to improve peoples' lives.

"It's toxic charity," says Rosen, using a term that is also the focus of a book by veteran activist Robert Lupton, "Toxic Charity: How Churches and Charities Hurt Those They Help (And How to Reverse It)."

"We saw bed nets that had been donated to combat malaria, but the people hadn't been properly educated how to use them," recalls Rosen. While she and the other volunteers took on that task, she wondered if a lack of education made such donations useless in other parts of the world as well.

Two boys in the orphanage in Bangalore, India, play on their new mattresses, complete with insecticide-treated bed netting.

Action with education = change

So she and her project partners focused their research on three "vital health-promoting behaviors" — tooth brushing, hand washing and the use of insecticide-treated bed nets, as they told UA's Board of Trustees when they gave a recent presentation on their work.

Known as participatory action research, their project combined generating knowledge on a subject with social activism — the opposite of toxic charity.

During the months leading up to Rosen's departure, the students continued developing their project and gained experience in a very important facet of research — fundraising. While Rosen had been awarded a Gibara Honors Scholarships for Study Abroad and funding from Sigma Theta Tau, an International Nursing Honors Society, to defray her expenses, they still needed to cover the cost of the supplies for the project.

Support from campus

"The Honors College gave us the Common Room to host a spaghetti dinner fundraiser, and so many local businesses gave us their support with donations of food and items for a drawing," says Snyder, of Mt. Gilead, Ohio. "Molly, her roommates and her parents helped cook the food at Molly's apartment and transport it to campus. It was a lot of work and very hectic, but we had more than 100 people at the dinner, and we surpassed our financial goal of raising $1,000."

It was an important challenge met, but there were more once Rosen arrived at her first location in India, an orphanage for boys, where she spent two weeks.

The "kiddos," as Rosen calls them, were bright and eager to learn, but the facility where they lived had few resources.

For example, the boys never had access to dental care, resulting in poor dentition, which made brushing their teeth painful and hazardous. Then, two days into the program, the city shut off water for a week. So she revised the program to emphasize malaria prevention.

Flexibility key to being effective

Rosen also discovered "even more pressing problems" — the boys slept on the ground and did not have any after-school activities, so they played in the streets of the slums. This resulted in greater risk of exposure to disease, and greater risk of succumbing to the dangers of street life. So, she consulted via Skype with her research partners, and together they decided to use part of their funds to purchase mattresses and pillows, along with science and comic books, games, sports equipment and art supplies.

Erin Rosen, surrounded by some of the "kiddos" at an orphanage in Bangalore, India, where she taught tooth brushing, hand washing and other health promoting behaviors last summer. They taught her how to play cricket.

"From the beginning, we understood we had to be flexible, because so much about working in a Third World country is unknown and unpredictable," says Arnold. "This was always about improving their quality of life first, and being our honors project second."

Rosen next spent time at a day care with 30 children under age 3. The "kiddos" there were so enthusiastic about learning to brush their teeth that they didn't want to stop. They brushed their teeth, the floors and the walls. So Rosen adapted again, developing a program that involved the children's parents.

New perspective

While the research project is now completed, this last year of study before graduation in May has continued to be busy for all three students. They are dividing their time between classes, clinical experience and work as student nurse technicians. All agree the ability to affect change so far away has given them a new perspective.

Snyder, who works at Summa Rehabilitation Hospital, near campus, hopes to continue work in a hospital setting and eventually become a hospital administrator. As a result of the Bangalore project, she has another goal.

"I see such a need now," says Snyder. "I am very interested in doing mission work after I get my nursing license. I want to stay involved."

Sharing the credit

Erin Rosen, Molly Arnold and Kelsey Snyder expressed appreciation to several people on campus for the success of their project, “An Examination of the Effectiveness of a Health Promotion Program on Children’s Bedtime Routines in Bangalore, India.”

They have singled out for special thanks Dr. Dale Mugler, dean of the Honors College, and School of Nursing faculty Dr. Marlene Huff, their project adviser, and Drs. Elaine Fisher and Christine Heifner-Graor.

It's a goal shared by Arnold, who has been working at Summa Akron City Hospital. She, too, likes the hospital setting and plans to one day earn a nurse practitioner's license.

"I definitely want to participate in medical missions, and I hope I can put my Spanish to good use," says Arnold, who earned a minor in Spanish while studying abroad in Valladolid, Spain, in 2010.

Mission work to continue

Rosen hopes to continue working in the Pediatric Intensive Care Unit at Akron Children's Hospital after graduation, and plans to earn an advanced degree as well. Future mission work is a given.

In fact, in March she heads to St Damien's Pediatric Hospital, in Tabarre, Haiti, with a team from Children's. The Akron team travels to this sister hospital twice a year to provide training and other assistance.

"We can be a voice for people who have none," says Rosen of the mission experiences. "We can bring back pictures and their stories and make it real for people back home.Most importantly, through our participatory action, we can empower people, who are the best resources of their own community, to influence their environment and health."